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25 | Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Required - Annual visit on 10/29/21 at 9:30AM. Administrator Certificate expired 7/31/21, however, documents and payment has been received by CCL and the updated certificate has not been received yet. LPA met with Harumi Hurrianko, Administrator regarding the purpose of todays visit. The facility is licensed for a capacity of 125 Non-Ambulatory residents. A hospice Waiver was approved to allow 15 residents to receive hospice care services. Currently there are 5 residents receiving hospice services.
LPA, April Luthe, Resident Care manager and Scott Okamoto, Marketing Manager, Administrator toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed and interviewed residents during this visit. LPA observed 2-day perishables and 7-day non-perishables. The temperature inside the facility was observed to be between 71-75*F which is within the required range of 68-85*F. The hot water temperature was measured in a random amount of rooms to be between 107.9*F and 111.2*F which is within the required range of 105-120*F.
LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents.
The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide.
Upon a file review the following items were discussed to be submitted with any changes annually:
Designation of Facility Responsibility (LIC308)
Liability Insurance
Personnel Report (LIC500)
Administrator Certificate-Updated
Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited during this visit. An exit interview was conducted. A copy of this report was provided. |